The harmful effects of tobacco use and smoking are so numerous that I haven't bothered to try to pull them together.  Tobacco kills an incredible 440,000 Americans every year.  That three times as many as Al-Qaeda killed on September 11th, 2001, each and every week, week after week, year after year.  Since 9-11, tobacco has killed over 1 million Americans or 400 times as many people as Osama Bin Laden!  Yet our governments do very, very little to stop tobacco deaths.  In fact, funding of tobacco prevention and tobacco cessation have been cut drastically in the last several years.

Surgeon General's 2004 Report: Surgeon General Richard Carmona add acute myeloid leukemia, cancers of the cervix, kidney, pancreas and stomach, abdominal aortic aneurysms, cataracts, periodontitis and pneumonia.. Diseases previously linked to smoking include cancer of the bladder, esophagus, larynx, lung and mouth. Also tied to smoking was chronic lung disease, chronic heart and cardiovascular disease, osteoporosis, peptic ulcers and reproductive problems. About 440,000 Americans die of smoking-related diseases each year. The report said more than 12 million people have died from smoking-related diseases in the 40 years since the first surgeon general's report on smoking and health was released in 1964. Treating smoking-related diseases costs the nation $75 billion annually. The loss of productivity from smoking is estimated to be $82 billion annually. On average, smokers die 13 years to 14 years before nonsmokers. AP 5/28/04.

Appendicitis/Appendectomy Increased: Lancet 1/30/99. The finding was true for both adults and for passive smoking in children. SM Montgomery, London.

Arthritis: Dramatic Increases in Rheumatoid Arthritis from Smoking: Annal Theu Diseases, Aintree, England article stuided 239 arthritis patients vs. controls. Those smoking 20 cigs or more for 40 years were 13 times more likely to develop RA vs. nonsmokers. 

Blindness Caused by Smoking: 70,000 in the U.S. Alone!: A new study from England has found that smokers are up to four times more likely to go blind in old age. Cigarettes do this by increasing the chances of developing age-related macular degeneration (AMD). Roughly, 856,000 older Americans have some degree of AMD. It results in severe and irreversible loss of central vision. Calculating from the data released by University of Manchester eye surgeon Simon Kelly, around 216,000 Americans have AMD as a direct result of smoking. Of these, 70,000 are completely blind. AMD has an earlier onset in smokers and continued smoking makes it harder to treat. Brit Med J 3/6/04. 

Breast Cancer Increased 60% by Smoking: Women who had smoked for 40 years or longer, the risk of breast cancer was 60% higher than that of women who had never smoked. Among those who smoked 20 cigarettes or more a day for 40 years, the increased risk rose to 83%. Smoking of very long duration and high intensity may be associated with increased risk of breast cancer, Albert Einstein; the women were followed for an average of 10.6 years (International Journal of Cancer 2002:100:723-8). The research, using data from almost 90 000 women in the Canadian national breast screening study.

Carpal Tunnel Increased: Mayo Clinic study found smoking a major risk factor cause nerves around carpal tunnels deprived of oxygen by vessel constriction of nicotine. ASH 7/2001.

Children of Smokers Blood Vessels Damaged: To measure oxidation injury, the Austrian researchers examined levels of a biological compound called 8-epi-PGF2alpha in the blood and urine of 158 children (71 boys, 87 girls) ages 3 to 15. The compound is formed when free radicals attack arachidonic acid, a chemical whose normal function includes blood vessel dilation, blood clot prevention and inflammation reaction. The children of smokers had a 50% increase. Henry Sinzinger, U Vienna, AHA Meeting 11/18/02.

Children of Smokers: Tooth Decay Increased by 2^nd Hand Smoke: Children subjected to environmental cigarette smoke developed higher blood levels of cotinine, a byproduct of nicotine, and those children tended to have more cavities in their deciduous, or primary, teeth. "Exposure to tobacco smoke nearly doubles a child's risk of having cavities," Andrew Aligne, University of Rochester, New York, and the Center for Child Health Research. 3,500 children aged four to 11 and concluded one-quarter of them would not have developed cavities in their primary teeth if environmental smoke was eliminated. JAMA 3/12/03

Death: Half of Smokers Will Die Prematurely: Overall, half of all smokers will die prematurely because of their habit. Half of these deaths occur in middle age (35-69 years). The report also implicates tobacco in five cancer sites not previously shown to be associated with smoking—the stomach, liver, uterine cervix, kidney (renal cell carcinoma), and myeloid leukemia. WHO, BMJ 6/29/02

Death: 440,000 Deaths per Year: CDC study increases annual death rate for 1995-9 period. 60% of the deaths are male. 1000 infants per year die. Cost to society in health care and lost wages $7.12 per pack.

Death: Cigars, Pipes Very Deadly: An analysis of data from 7 case-control studies in Europe of 5600 male lung cancer victims and 7200 controls found lung cancer RR for cigar smoking 9.0, pipe smoking 7.9 and cigarettes 14.9. A dose-response relationship was present for cigars and for pipe smoking. Inhalation of cigars also increased the risk. Thus, cigar and pipe smoking may be almost as bad as cigarettes. J Natl Cancer Inst ’99;91:697-701. 4/21/99

Dementia: Smoking More than Doubles Alzheimer's Disease: 2820 adults over age 59 were followed for two years. A total of 121 incident cases of dementia were detected, of which 84 (69%) were Alzheimer's disease, 17 (14%) were vascular dementia, and 21(17%) were other dementia. Compared with never smokers, current smokers had an increased risk of Alzheimer's disease (RR = 2.72; 95% CI = 1.63-5.42) and vascular dementia (RR = 1.98; 95% CI = 1.53-3.12) adjusting for age, sex, education, blood pressure, and alcohol intake. Compared with light smokers, the adjusted risk of Alzheimer's disease was significantly increased among smokers with a medium level of exposure (RR = 2.56; 95% CI = 1.65-5.52), with an even higher risk of Alzheimer's disease in the heavy smoking group (RR = 3.03; 95% CI = 1.25-4.02). A 2-year follow-up study of cigarette smoking and risk of dementia. Juan D, Zhou DH, Li J, Wang JY, Gao C, Chen M. Chongqing, China.  Eur J Neurol. 2004 Apr;11(4):277-82

Dementia: Smoking Causes Mental Decline in Nondemented Elderly: 17,610 persons over age 64 were followed for 2.3 years and 11,003 were retested. Mini-Mental State Examination (MMSE) score of persons who never smoked on average declined 0.03 point/year. The adjusted decline of former smokers was 0.03 point greater and of current smokers 0.13 point greater than never smokers (p < 0.001). Higher cigarette pack-year exposure was correlated with a significantly higher rate of decline. Effect of smoking on global cognitive function in nondemented elderly. Ott A, Andersen K, Dewey ME, Letenneur L, Brayne C, Copeland JR, Dartigues JF, Kragh-Sorensen P, Lobo A, Martinez-Lage JM, Stijnen T, Hofman A, Launer LJ; EURODEM Incidence Research Group. Erasmus University, the Netherlands. Neurology. 2004 Mar 23;62(6):920-4.

Depression: Smoking More Than Doubles Depression: Pediatrics 10/00. Prospective study of over 8,000 teens found 4.8% of non-smokers developed depression in 1 yr follow-up vs. 12% of smokers. U Cinn

Depression: College Study Nicotine Dependence Strongly Associated to Alcohol Abuse, Depression, and Anxiety: In a random selection survey of 328 Turkish college students, those with nicotine dependence had a 70% rate of alcohol abuse vs. 15% for non-smokers. Smokers were much more likely to be depressed (36% vs. 15%) or have an anxiety disorder (29% vs. 13%). Nicotine dependence and psychiatric comorbidity among university students. Cilli AS, Kaya N. Turk Psikiyatri Derg. 2003 Spring;14(1):42-9. 

Depression Less After Stopping Smoking: Continuous abstinence was associated with short- and long-term reductions in depressive symptoms. Major Depression Disorder incidence during follow-up was 15.3% and was not associated with abstinence. Unexpected was that cognitive behavior therapy was associated with greater negative mood and depressive symptoms. 179 smokers with MDD attempting to stop were in study. Brown Univ. Negative mood, depressive symptoms, and major depression after smoking cessation treatment in smokers with a history of major depressive disorder. Kahler CW, Brown RA, Ramsey SE, Niaura R, Abrams DB, Goldstein MG, Mueller TI, Miller IW. J Abnorm Psychol 2002 Nov;111(4):670-5

Depression Dropped Quickly in Small Study: A DB PC study of just six depressed smokers found that those assigned to placebo patches had their depression decrease just as much as those assigned to nicotine patches. There was a significant decrease already on the second day. The effect of nicotine patch therapy on depression in nonsmokers: a preliminary study. Cox LS, Patten CA, Krahn LE, Hurt RD, Croghan IT, Wolter TD, Schroeder DR, Tri D, Offord KP. J Addict Dis. 2003;22(4):75-85

Depression 150% More Common in German Smokers; Depressed Quit Smoking at Same Rate: A random population sample of 4056 German adults found 14% of non-smoking females depressed and 32% of smokers. For males, 6% of non-smokers and 13% of smokers were depressed. Smokers were followed for three years. Depressed smokers had the same quit rates as non-depressed smokers. Depressive disorders are related to nicotine dependence in the population but do not necessarily hamper smoking cessation. John U, Meyer C, Rumpf HJ, Hapke U. J Clin Psychiatry. 2004 Feb;65(2):169-76. Ed: Smoking is very common in Germany thanks to no age laws and German tobacco companies having a powerful control of German politicians. Corruption is not just in America. 

Grey Hair & Baldness Increased by Smoking: A study of 600 males and females found smoking doubles baldness (OD 1.93) and quadruples presence of grey hairs (4.40). BMJ 313:1616.

Impotence: 500,000 Impotent Men, 5,000 Cervical Cancers/Year, 18,000 Spontaneous Abortions/Year Due to U.S. Smoking!: Calculating from a new British study which found that about 120 000 men in the United Kingdom aged 30 to 50 are impotent because of smoking, and that smoking about 1200 cases of malignant cervical cancer and around 3000 to 5000 miscarriages every year there, the impact on the U.S. is also disastrous. Women who smoke reduce their chances of conceiving by up to 40% each month, and couples who smoke are less likely to respond to infertility treatment. In pregnancy smoking increases the risks of miscarriage, certain fetal malformations, such as cleft lip and palate, and stillbirth and death of the newborn. It triples the chances of having a low birthweight baby and reduces the quality of breast milk. In infants and children, passive smoking can cause sudden infant death syndrome, respiratory infections, and asthma. Dr Vivienne Nathanson, the BMA's head of science and ethics, said: "The sheer scale of damage that smoking causes to reproductive and child health is shocking. Women are generally aware that they should not smoke while pregnant, but the message needs to be far stronger." BMJ  2/14/2004;328:364 

Injury Death Markedly Increased by Smoking: An international review and meta-analysis found extremely strong p values showing increases in deaths due to injury independent of alcohol in the amount of 69%. UC-Davis, Prev Med 11/98;27:871

IQ Damaged and Thinking Dull from Smoking; Worse Than Alcohol!: In a 9-year follow-up study of 172 alcoholic and non-alcoholic men found, as expected, that alcoholism is associated with thinking problems and lower IQ, but their analysis also revealed that long-term smoking is too. The effect on memory, problem-solving and IQ was most pronounced among those who had smoked for years. Smoking was associated with diminished thinking ability even after alcohol and drug use were accounted for. Jennifer Glass, et al. University of Michigan. Drug and Alcohol Dependence 10/13/05. Many alcoholism-recovery programs don't emphasize quitting smoking, even though smoking can be a social and possibly chemical "cue" associated with alcohol consumption. Researchers at the University of California, San Francisco, found that alcoholics who smoke have lower brain volume than alcoholics who don't smoke. There is a growing body of evidence for a link between long-term smoking and thinking ability. The higher the pack-years and lifetime alcoholism severity scores, the lower the global cognitive proficiency scores and IQ. The impact of heavy lifetime smoking history was greater than the effect of lifetime drinking history.

Kidneys & Spleen Damaged by Smoking: By lowering MAO-B, which breaks down neurotransmitters and BP regulators, these chemicals are active longer than normal. PET scans show 33-46% lower MAO-B activity in heart, lungs, kidney, and spleen of smokers. Nora Volkow, NIDA, Wash. Reuters 9/8/03

Multiple Sclerosis Up in Smokers: Harvard study of women found a pack a day for 25 years more likely to develop multiple sclerosis by 60% compared to non-smokers. Also linked to lupus and rheumatoid arthritis in the past. Am J Epid 2001;154:69-74

Pets Killed by Smoking Owners: In a study in the Amer J Epidem, dogs in smoking household had a 60% greater risk of lung cancer. Also, long-nosed dogs were twice as likely to develop nasal cancer if they lived with smokers. A third study by Tufts University vets found that cats whose owners smoked were three times more likely to develop lymphoma, the most common feline cancer (ASH Review 4/2004).

Suicide Attempts Increased and Serotonin Decreased by Smoking: Among all 347 depressed and schizophrenic patients, smokers were more likely to have made a suicide attempt (adjusted odds ratio=2.60, 95% confidence interval=1.60-4.23) and had higher suicidal ideation and lifetime aggression scores, compared with nonsmokers. An inverse relationship was observed between amount of cigarette smoking and both indices of serotonin function. Cigarette smoking, suicidal behavior, and serotonin function in major psychiatric disorders. Malone KM, Waternaux C, Haas GL, Cooper TB, Li S, Mann JJ. Am J Psychiatry. 2003 Apr;160(4):773-9, Columbia U

Smoking High in Bipolars, Schizophrenics: A study of 2774 psychiatric outpatients found that 61% smoked daily and 18% heavily. Smoking was especially related to diagnoses of bipolar disorder, schizoaffective disorder, and schizophrenia an association that was most pronounced among the most severe, even after controlling for other substance use. Cessation programs are needed. Univ. Syracuse. Smoking among psychiatric outpatients: relationship to substance use, diagnosis, and illness severity. Vanable PA, Carey MP, Carey KB, Maisto SA. Psychol Addict Behav. 2003 Dec;17(4):259-65. Ed: I have stop smoking treatments and encourage all smokers to get into treatment now.